HomeMy WebLinkAbout2014-08-06 P & R Packet CITY OF CENTERVILLE
PARKS & RECREATION AGENDA
Wednesday,August 6,2014—6:30 p.m.
I. CALL TO ORDER
1. Roll Call
II. SET AGENDA
III. APPEARANCES
IV. CONSIDERATION OF MINUTES
1. Parks & Recreation Committee Minutes of July 2,2014
V. COMMITTEE BUSINESS
1. Centennial High School Baseball Boosters Request for Sponsorship
2. Special Event Permit Application -Tri Fitness—My First Tri w Requesting Use of Trails
Through Town/LaMotte Park for August 23,2014 Event(6:00 a.m.— 12:00 (Noon)
3. Festival of the Lakes 5K,8K& Kids Free % Mile Runs (Recap)
a. Sponsorships (Stantec $200 Coming)
4. Music in the Park/Jam (ReCap)
5. Special Event Permit/Park Facility Usage Form—Private Birthday Party,August 2,2014
LaMotte Park Pavilion (12:00 noon to 3:00 p.m.)—Staff Approved
6. Estimates for: Installation of Basketball Court(Hoops/Backboards—LaMotte),Water
Fountains (LaMotte & Acorn Creek Park) & Electrical Services (LaMotte Pavilion)—P.
Palzer—To be Discussed
VI. UPDATES
1. Council Updates—Council Member Steve King(Centerville Lions Donation)
On-Going Items
VII. ACTION ITEMS) REVIEW
VIII. ADJOURNMENT
*REMINDERS**
City Council Meeting—August 13, 2014, 6:30 p.m. (Council Chambers)
City Council Meeting—August 27,2014, 6:30 p.m. (Council Chambers)
Planning&Zoning Commission Meeting—September 2, 2014, 6:30 p.m. (Council Chambers)
Parks &Recreation Committee Meeting—August 6, 2014, 6:30 p.m. (Council Chambers)
July 29, 2014—First day to File Affidavits of Candidacy for Municipal Office
August 12, 2014—Last day to File Affidavits of Candidacy for Municipal Office (5:00 p.m.)& State Primary
Election, St. Genevieve Community Parish Center, 6995 Centerville Road(7:00 a.m. —8:00 p.m.)
August 14, 2014—Last day to Withdraw(5:00 p.m.)
PARK USAGE RESERVATIONS
Ms. Jaci Smetana, Fitness Classes, Parking Lot, Football/Soccer Fields/Shelter, LaMotte Park—April 28
through October 31, 2014, Monday through Thursdays from 5:30-6:30 a.m.
Centennial Youth Football, LaMotte Park, Fields#1, #2 and 11 —August 1 through October 30, 2014 5:00 p.m.
to dark(Tuesday&Thursday evenings & Saturdays late morning/early afternoon)
Centennial Soccer Club, LaMotte Park, Fields#1, #2, #11 &Baseball Outfields—August 1,through October
30, 2014, 5:30 p.m. to sunset (Monday&Wednesday evenings) &Acorn Creek Park
Centennial Little League, Ball field#3, #4 and possibly#5, LaMotte Park—August 1 through October 30,
2014, Monday through Fridays from 4:00 p.m. to dark
Private Birthday Party, LaMotte Park Picnic Pavilion—August 2, 2014, 12:00 (noon)—3:00 p.m.
My First Tri (Tri Fitness)—August 23, 2014 Trails Through Town, 6:00 a.m.— 12:00 (noon)
Centennial Baseball Boosters— September 27, 2014 w/Alternate Date September 28, 2014 (5K& 1 OK Run
Through Park on Trails&Through Town), 6:30 a.m. — 11:00 a.m.
PARKS AND RECREATION COMMITTEE
Wednesday,July 2, 2014—6:30 p.m.
Pursuant to due call and notice thereof, the Parks & Recreation Committee of the City of
Centerville held a scheduled meeting on Wednesday, July 2, 2014 at the City Hall location.
Present: Chairperson Patrick Branch
Committee Member Kevin Amundsen
Committee Member Brian Peterson 0 Q
Committee Member Nick Twohy 0
Committee Member Kevin Waeghe D
Also Present: Council Member, Steve King
Absent: Vice-Chairperson Jon Grahek
Committee Member Chris Bettinger
Committee Member Suzanne Seeley
Public Works Director, Paul Palzer
I. CALL TO ORDER
Chairperson Branch called the July 2, 2014 Meeting of the Parks & Recreation Committee to
order at 6:32 p.m. at the City Hall location.
Roll Call—see above
II. SET AGENDA
Motion was made by Committee Member Branch, seconded by Committee Member Waege
to set the agenda. Under COMMITTEE BUSINESS: by adding number 3. BudEet
Protections and under UPDATES: by adding number 3. Run update, number 4 Anoka
County Master Plan and number 5. Movies in the nark. All in favor. Motion carried
III. APPEARANCES—NONE
IV. CONSIDERATION OF MINUTES
Motion was made by Committee Member Amundsen, seconded by Committee Member
Twohv to approve the June 4, 2014 minutes as written except to add Pat Branch as the
transcriber. All in favor. Motion carried.
V. COMMITTEE BUSINESS
1. Park Benches/Installation/Labor—Pat Branch
1
The actual cost of the five benches was $2679,materials (lumber& cement) for
installation was $578 and the cost for labor to install them was $1141. There was
some concern regarding the cost of the labor and whose responsibility it should be
to pay for the labor costs for the installation of park projects. In the future, when
a motion is made, the motion should include a request to the city to budget and to
pay for the labor for the installation of park projects. This item was tabled to the
August meeting.
2. Basketball Court/Backboard—Paul Palzer
Mr. Palzer was not in attendance at this meeting,but information was provided to
the Committee for several options for backboards. The Committee prefers the
gooseneck style and would cost approximately$1500 each, for a total of$3000,
plus the cost of materials to install them. This item was tabled to the August
meeting.
3. Budget Projections—Pat Branch
The 2014 project that the Committee is planning and obtaining bids for include a
basketball court in the area of the ice arena. Other projects for the future include
Water Fountains in the Laurie LaMotte and Acorn Parks, Electrical Drops at the
Laurie LaMotte Park, Tree Trimming in Hidden Spring Park and a new Popcorn
Machine. Currently there is $901 that can be earmarked for the Basketball Court.
It is expected (or hoped) that additional donations will be received before the end
of summer to allow the completion of the Basketball Court.
VI. UPDATES
1. Council Updates—Council Member Steve King
Mr. King reported that an additional $500 donation was recently received by the
Lions. There is a purchase agreement between the city and the St. Paul Water
District for the purchase of the land by Trailside Park. The City Council adopted
the Chain of Lakes-Bald Eagle Trail.
2. Flag Football Tournament - Pat Branch
The second half of the tournament was rained out. To date, none of the waivers
have been turned in for the May/June tournament and no money has been
received to cover the cities expenses. No permit request has been received for the
August 9/10 tournament. Committee Member Branch has emailed Mr. Teng
Moua twice requesting an update and to date has not received a response; he will
follow up and if no response the August date may not be approved.
3. Festival of the Lakes Runs—Pat Branch
2
The runs are scheduled for July 26th with the 8K& 5K starting at 8:00 am and the
Kids Run starting at 9:00 am. Teams of 5 will pay for 4 members and the 5th
member is free. Several sponsors have made a commitment and Committee
Member Branch will follow up with them. Mr. Greg Berger will oversee all
recycling with Waste Management providing recycling containers. He will also
place the signage.
Discussed purchasing a business card size ad for $100 to be included with the
Lions ad in PUBLICATION?; it will be distributed on July 24th, but need to find
out the submission date. The Committee approved this by consensus. The Teams
of 5 discount will be included in this ad.
The Lions Club and Kelly's have teamed up to sponsor the street dance in Kelly's
parking lot with free parking at the school.
4. Chain of Lakes—Bald Eagle Regional Tail Master Plan
The City Council adopted the Chain of Lakes-Bald Eagle Trail.
VII. OTHER
1. Movies in the Park—Brian Peterson
This activity is scheduled for September, 2014. Committee Member Peterson
asked for additional ideas for movies;Frozen &the Lego Movie are two options.
2. Jam Session
The average attendance for the Music in the Parks has been approximately 30
each week. Discussed serving ice cream at the Jam Session, which is the last
event.
VIII. ACTION ITEMS REVIEW
Items that have been completed will be removed; some are still open and additional items
discussed at this meeting will be added. A revised Action Item List, as of the March 5, 2014
meeting will be included with the minutes to be approved.
Items that have been completed as of July 2,2014 will be removed:
• These include item numbers: 14-013 & 14-017
Items that are to be deleted as of July 2, 2014 will be removed:
• These include item numbers: NONE
Corrections/Revisions: NONE
3
Items to be added are:
14-018 —Obtain estimates on cost of installation of the Basketball Court hoops/backboard.
14-019 - Obtain estimates on cost of installation of Water Fountains in Laurie LaMotte
and Acorn Parks.
14-020 — Obtain estimates on cost of installation of Electrical Service in Laurie LaMotte
pavilion.
The person assigned to these above 3 items is Paul Palzer,Date: ASAP,Status: Open
Items that are priority items and need to be done ASAP are item numbers: NONE
Change dates to Ongoing: 13-022 & 14-016
IX. ADJOURNMENT
Motion was made by Committee Member Amundsen, seconded by Committee
Member Twohy to adiourn the meeting. Meeting was adjourned at 7:29 p.m. All
in favor. Motion carried.
Submitted by: Linda Neudecker, Secretary
4
ACTION ITEMS
PARKS RECREATION
Assigned
# Item Person Date Status
Trailside Park Benches - Bald Eagle Ski
12-006 Club Landscaping P. Branch On-Going Oen
Nick Twohy
Kiosk- Cornerstone Park- Create Inserts for &Kevin
12-013a Kiosk Waeghe On-Going Oen
Kiosk @ Cornerstone Park-Remove All
Outdated Materials &Replace Seasonal
12-013b Programs/Events Staff On-Going Open
Investigate Possibility of Hockey Rink as
Basketball Court in Summer(Need Approx. B. Peterson&
13-022 $3,000) Paul P. On-Going Open
13-028 Plan to Address Signage for Indian Mound S. Seeley On-Going Open
13-029 Plan for Parks Irrigation P &R On-Going Open
Send request to these organizationsfor
donation of funds (Dead Broke, Centennial
Youth Hockey, Shake Your Shamrock/Front
Runner& Centerville Lions Club)to be used
14-001 for basketball court P. Branch On-Going Open
14-004 Park Shoreline Clean-up @ Hidden Springs P. Branch On-Going Open
Fete des Lacs - Friday, July 25-Sunday, July
14-008 27 On-Goin
14-010 Chain of Lakes - Master Plan On-Going Tabled
City/Ski Club Purchase of St. Paul Water
14-012 District Staff/Dallas On-Going Open
K.
Amundsen/Sta
14-016 Park Use Application Forms - Uniformity ff On-Going Open
Estimate of Cost- Installation of Basketball
14-018 Court(Hoops/Backboard) P. Palzer ASAP Open
Estimate of Cost- Installation of Water
14-019 Fountains in LaMotte&Acorn Creek Parks P. Palzer ASAP Open
Estimate of Cost- Electrical Services at
14-020 LaMotte Pavilion P. Palzer ASAP Open
Following July 2,2014 Meeting Page 1
Park Project Estimates
JEsL nUdoftlljai`,_ - �• _��- �� _� --
Basketball hoops $2810
Cost is from meeting handout, (www.summitsur)plvcolo.com) PK 6015 heavy duty gooseneck
package 43x60 white powercoated steel backboard
Water fountains
LaMotte and Acorn Parks
Electrical Drops LaMotte
Pavilion
Funding Staff Budget Projected Explanatm
Figures
2013 remaining $601 This is based on
data from Kris
and note from
Dallas 7/2/12
Lions 2014 donation $500
2014 Festival of the Lakes $2500 WAG We will not have
based on a hard figure until
2013 all donations and
bills are
received/paid.
Maybe by Sept
Totals $1101
Conclusion: We have a min. of$1101 on hand -Now- That could be spent on projects.
5K/10Z
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Centennial High School Baseball Boosters
A 501 (c) (3) Tax-Exempt Public Charity
A Minnesota Non-Profit Corporation
MN File No. 6454581010022 (pending)
EIN 46-1009977
Dear Sponsor,
The Centennial High School Baseball Boosters is a non-profit group organized to financially
assist our local high school baseball teams. The Boosters aid the Centennial High School
Baseball Program through contributions used for equipment, fields, scoreboards and other
improvements. Quality programs reflect our community's priorities and help our young people
know we value their commitment to achieve.
On September 27, 2014, we will hold a 5k/10k race to raise funds to improve our baseball fields
and programs. Race t-shirts are given to each participant. Advertisements on the t-shirts
provide wide exposure for businesses. Would you please consider assisting our baseball program
with one of the following donations?
1 Primary Race Sponsor - $350. At this high impact level of advertising, your establishment
would be named as the predominant sponsor (large letters) on the back of approximately
200 t-shirts.
2 Secondary Race Sponsor - $250. Your establishment would be advertised on approximately
200 t-shirts (under the primary race sponsor).
3 Gift card (used as a race prize).
We welcome your participation in the "Diamond in the Rough" 5k/l0k race around
Centerville Lake in Anoka County on September 27, 2014! For more information, please
contact Mary Adams at 651-955-6493. Donations can be mailed to the address below.
Thank you so much for your support!
Sincerely,
Centennial High School Baseball Boosters
575 Birch Street, Lino Lakes, MN 55014 • CentennialBasebaE3oosters@gmail.com
To REGISTER,go to Midwest Events, https://www.midwestevents.com/events_details.php?e_id=1839
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Centerville
Special Event Permit Application
1. TI LE;PWSE,AND BRIEF DESCRIPTIQN,OF EVENT: �y rS t Y
011 r)ashlQh SWIM, 21141 KLtn
New Application: Renewal of orC
hange in Application:
CONTACT PERSON n PK"t 051 "f� A
P - 1 1 (01
TELEPHONE: OR
2. IDENTIFYING INFORMATION:
Attach a written communication from the organization(s) in whose name the event will be advertised which
authorizes you,the applicant,to apply 1 for this special event permit on its/their behalf.
Applicant's Name: jQ�i SJR e(t Title: Qeb No r�
Address: ( I
Mailing Address:
Affiliation: `, rl -rNS S
Day Phone: I gal 4Q: r, L C (Q—Evening Phone:
Emergency Phone: VIA 102) 9U(05:
3. EVENT PRINCIPALS:
Following, please list the names, addresses and telephone numbers of all the principals involved in any of the
proposed special event. Include professional event organizers,event promoters,financial underwriters,commercial
sponsors,charitable agencies for whose benefit the event is being produced,the organization(s)in whose name the
event is being advertised,and all others administratively, financially and organizationally involved as principals in
the production of the proposed special event. Make additional copies of the following as needed to include as of the
principals involved
�inthe proposed special event.
NamVe: u6 , �i c v-1 L csitn d o r-(
Organization/B Try S
Is this a non-profit organization? Yes No
If you are making application under non-profit status,proof of non-profit status must be attached to this application
Mailing Address: SAJ)AL as a6V4,,
Day Phone: Evening Phone:
Title and functional responsibility with regard to the event:
Page 1 of 10
4. REQUESTED EVENT COMPONENTS:
Date requested: 2� 114- Alternate date:
Requested hours of operation: 2 AOO (a.m./p.m.)To: (a.m./p.m.)
Set up beginning date and time: Q h1 X23
Complete dismantle date and time: tJ U0r� 2)123
Describe the number and type of animals(if any)to be used in this event: 1'10 r)e,
Attach a draft of the entry form for participants and/or spectators.
Anticipated number of participants: 150 Spectators:
5. INSURANCE:
Attach to this application either an insurance policy or a certificate of insurance including the policy number,
amount, and the provisions that the City of Centerville is included as an additional insured. (Please note that
insurance requirements depend upon the risk level of the event. Also, if your event can be classified as first
amendment expressive activity,insurance requirements can be waived under certain circumstances.)
6. SANITATION:
Attach your"Plan for clean-up/Material Preservation". Include number,type and location of trash containers to be
provided for the event. Indicate who and how man will be responsible for emptying and cleaning up around
containers during the event. Indicate who and how many will be responsible for cleaning up after animals if they are
present during the event. Indicate who and how many will be responsible for cleaning up after the event. Describe
the number,type and location of portable toilets to be provided for the event(or permanent toilets to be used in the
event.) Include any other plan you have for ensuring post-event cleanliness and material preservation of city
facilities,equipment,premises and streets. A deposit of$500 will be required for clean-up and restoration. If
Premises are lett in satisfactory condition,this deposit will be refunded in full following inspection.
7. LOCATION:
Please attach a map of your event land design. Check off below items that apply to your event
and indicate them on the attached map. Use,where necessary, a"to scale"drawing.
A. If a route is involved,the beginning and finish area with arrows.
B. If a route is involved,the places where buses,autos or other motorized vehicles need to
be considered.
C. If a route is involved,attach separate maps giving two or more alternate routes.
D. Entertainment or stage locations(grandstand operators should provide you with a
"to scale"drawing.)
E. Alcoholic beverage concession area.
F. Non-alcoholic concession area.
G. Food concession area.
H. General Merchandise concession areas.
1. Portable toilet facilities(indicate number).
J. Event participant and/or spectator parking areas.
K. Event organizer's command post.
Page 2 of 10
L. First aid facilities.
M. Fireworks or pyrotechnics site.
N. Vehicle fuel handling sit.
O. Cooking areas.
P. Electrical sources to be used for cooking.
Q. tables,enclosures,etc.
R. Temporary or permanent structures constructed for the event.
S. Site of electrical wiring to be installed for the event.
T. Trash receptacles(indicate number)
U. Other- Please describe.
8. AVAILABILITY OF FOOD,BEVERAGES AND/OR ENTERTAINMENT:
If there will be music, sound amplification or any other noise impact, please describe, including
the intended hours of the music,sound or noise:
Will alcoholic beverages be served? Yes No
PLEASE NOTE THAT SALES OF LIOUOR/ALCOHOL IS PROHIBITED IN CITY
PARKS UNLESS THE EVENT IS A CITY CELEBRATION AND PRIOR APPROVAL
AND APPROPRIATE LICENSES ARE OBTAINED BY CITY COUNCIL ACTION.
If yes,describe what system will be used to ensure that alcoholic beverages will be consumed by
persons 21 years and older:
0 it-
If yes,describe how,where,when and by whom the alcoholic beverages will be served:
If a casino party, a dance,or live ent inment is part of your event,please describe:
Please describe all of the activities of your event for which a license is required, for example: a
cabaret license, etc. Attach all required licenses to this application. Please note that certain
licensing mal be required by City, County and State agencies, such as a Large Assembly
License for gatherings over 1,000 people, some types of food handline licensing, Gambling
License,Cabaret License,etc. It is your responsibility to check with the Citv Clerk or local
authorities to determine what licensing is required prior to submitting this application
Page 3 of 10
Will food and/or non-alcoholic beverages be served? Yes No
If yes, describe sanitation measures, food handling procedures and the nature of the food(such as
pre-packaged foods, hot dogs, pre-mixed soda, unpeeled fruit, raw meats, vegetables, fish or
peeled and cut fruit.)
If yes, you will need a permit from the Anoka County Department of Environmental
Health. Please attach a copy of the permit to this application.
9. SECURITY AND SAFETY PROCEDURES:
escribe your pro sed procedures for set u operation, tsee'
' and crowd control: _
v�� S t �. ��i2 C X123 0 Vc��l � o COarse
tin M I un
If the event is to occur at night, describe how you are going to light the event area in order to
increase the safety of participants and spectators coming to and leaving the event:
If your event includes vehicles or animals, describe the minimum and maximum speeds of the
event and the minimum and maximum intervals of space to be maintained between units:
Attach to this application a copy of your building permit(s) if you are installing any electrical
wiring on temporary or permanent basis and/or if you are building any temporary or permanent
structures such as bleachers, scaffolding,a grandstand, stages or platforms.
Attach a copy of your fire department permit(s) to this application if you will use parade floats;
an open flame; fireworks or pyrotechnics; vehicle fuel; cooking facilities;enclosures(and tables
within those closures);tents, air supported structures,canopies,or fabric shelters.
Give the name,address and phone numbers of the agency or agencies which will provide first aid
staff and equipment i��f''required.
��Attach additional sheets if necessary.
Name of a�*.
Name of Representative:
Address:
Day phone: Evening phone:
Indicate medical services(if required)that will be provided for this event:
Page 4 of 10
Ambulances: Doctors:
Nurses: Paramedics:
10. VENDORS OR CONCESSIONAIRES:
Describe what vendors/concessionaires you will allow in conjunction with the event, and the
purpose of these concessions:
Describe how you intend to regulate, monitor and control the type, number and quality of
vendors/concessionaires whom you may permit to operate in conjunction with the event:
11. CITY SERVICES/EQUIPMENT:
Describe city services and/or equipment requested for this event: City barricades, cones, signs,
picnic tables and other equipment which may be borrowed on an as-available basis. You should
make advance arrangements to pick up and return this equipment. If you or any volunteers
cannot pick up and return this equipment, please attach a letter requesting these services and
explaining why your organization cannot perform them. This will be reviewed,then approved or
denied by the public works foreman.
I VV
12. OTHER PERTINENT INFORMATION:
Please list below any other miscellaneous information you feel would be important and have a
bearing on the approval of this Special Event Permit request:
13. FEE STRUCTURE/EVENT CHARGES:
If there is a fee or donation required as a condition of attendance or participation of this event,
please describe the amounts to be collected from various categories of participants or spectators:
14. If a donation is requested on a purely voluntary basis, describe how you intend to inform
participants/spectators or others that they may participate in the event whether they make a
donation or not: h " 0 i
�r
Page 5 of 10
Centerville
Special Event Permit ,�
NAME AND TYPE OF EVENT: _T-�(St ti a4( �10�y�1
DAY,DATE AND TIME: �3 I-n I I'T obam— n oo n
1. PARKS AND RECREATION DEPARTMENT
FINAL APPROVAL AND SIGN OFF
Signature Title
Date:
Please check or use N/A(not applicable)where appropriate:
1. Final check has been made of application requirements.
2. Event is approved by City Council.
3. All required permits are issued and on file.
4. Refundable clean up fee has been paid.
5. Insurance Certificate is on file with City Clerk
6. Surety Bond is on file to secure payment for applicant's obligation to the
City.
7. Application is complete.
8. Special conditions are attached.
REVOCATION: Upon mutual consent, the City Council may revoke a special event permit if
the conditions set fourth in the permit application are not being followed.
Permit is hereby revoked:
Signature Title
Date:
Reason(s)for revocation:
TO BE REVIEWED/APPROVED AND SIGNED BY AFFECTED
CITY DEPARTMENT HEADS
Page 6 of 10
2. PARKS AND RECREATION DEPARTMENT
Special Events Coordinator: Date:
Initial/sign-off-
3. POLICE DEPARTMENT
Approved by:
Signature Title
Date:
1. Emergency vehicle access.
2. Traffic/safety street closures.
3. Appropriate barricades.(# Required)
4. Police personnel required/available.
5. Portable toilet facilities. (# Required)
6. First aid facilities.
7. Internal security and crowd control.
8. nighttime lighting.
9. Other provisions as may be required by this department.
4. LICENSING AND INSURANCE
Approved by:
Signature Title
Date:
1. Dance and/or live entertainment.
List types or permits or licenses required:
2. Alcoholic beverages.
3. Peddlers.
4. Noise abatement.
5. Other provisions as may be required:
INSURANCE: Your insurance coverage must be reviewed and approved by the
City's insurance carrier.
Page 7 of 10
1. Public liability insurance naming City of Centerville and other public agencies
additionally insured is required.
2. Hold harmless forms executed and failed.
3. List and approve/disapprove other insurance coverage as may be required.
5. FIRE DEPARTMENT
Approved by:
Signature Title
Date:
1. Emergency vehicle access.
2. Use of fireworks,pyrotechnics, vehicle fuel,open flame.
3. Cooking facilities.
4. Occupancy and spacing of tables,enclosures.
5. Parade, floats.
6. Tents, air supported structures,canopies.
7. Other provisions as my be required by this department:
6. BUILDING DEPARTMENT
Approved by:
Signature Title
Date:
Electrical:
1. Plan check/inspection of any wiring installed on a temporary or permit basis.
2. Permit(s)attached.
Structural Plan:
1. Plan check/inspection of any temporary or permanent structures, including
bleachers,scaffolding, grandstand,reviewing stands, stages,or platforms.
2. Permit(s)attached.
3. Other provisions as may be required by this department:
Page 8 of 10
7. PARKS AND RECREATION DEPARTMENT
Approved by:
Signature Title
Date:
1. Park permit(s)required.(to be attached)
2. Ballfield Usage Permit.
3. Beach permit required. (to be attached)
4. Trash containers required. (#`)
5. Portable toilets required. (#
6. Applicant's plan for cleanup, site restoration and material preservation
(recycling)required and attached.
7. Other provisions as may be required by this department:
S. PUBLIC WORKS DEPARTMENT
Approved by:
Signature Title
Date:
1. Trash containers required. (#`)
2. Portable toilets required. (#
3. Special animal clean up required.
4. Barricades provided, as available.
5. Cones provided,as available. (#
6. No parking signs provided, as available. (#i)
7. Applicant's plan for clean up and material preservation(recycling)required
and attached.
8. Other provisions as may be required by this department:
9. STATE,COUNTY AND CITY HEALTH DEPARTMENT
Approved by:
Signature Title
Date:
1. Food and/or beverage served.
2. Permit(s)attached.
Page 9 of 10
3. Food cooked.
4. Permit(s)attached.
5. List other health licensing obligations as may be require:
Page 10 of 10
ACC>R b® CERTIFICATE
OF LIABILITY INSURANCE DATE(M
THIS CERTIFICATE IS SUEQ AS A MATTER OF INFO7/15/2014
CERTIFICATE DOES NOT AFFIRMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOL ER. THIS
MATIVELY OR NEGATIVELY AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE pOtiCifS
BELOW. THIS CERTIFICATE OF INSURANCE DOES NOT CONSTITUTE A CONTRACT BETWEEN THE ISSUING INSURER(S), AUTHORIZED
REPRESENTATIVE OR PRODUCER,AND THE CERTIFICATE HOLDER
IMPORTANT: c the conditions of certificate holder hs an ADDITIONAL INS11 URED
the teens and c ,the pollcyI l 8)must be endorsed. If SUBROGATION IS WAIVED, subject to
the policy,certain policies ma
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lder in lieu of such endorseme y require an endorsement A statement on this certificate does not confer rtghts to the
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MN 55117-1940M►suRE s AFFORDINOCOVERAGE
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WHITE BEAR LAKE MN 55110 INSURER E:
COVERAGES CERTIFICATE NUMBER:2014 GL/SpLUMIU
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THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSUREOAR1EOp A6UMBEUR THE POLICY PERIOD
INDICATED. NOT4i9TFiSTANDIt:^v ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIB E'D HEREIN IS SUBJECT TO ALL THE TERMS,
EXCLUSIONS AND COVO!TIONS OF SUCH POLICIES.LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. WHICH THIS
INBR
TYPE OF INSURANCE POLICY EFF POLICY
(ENS , N R LIMITS
X COMMERCIAL GENERAL LIABILITY EACH OCCURRENCE $ 1,000,000
A CLAIMS-MADE OCCUR SN2150532 PR MI a S 200,000
/14/2014 /14/2015 MED EXP(Any one reon) $ 10,000
PERSONAL&ADV INJURY $ 1,000,000
GEWL AGGREGATE LIMIT APPLIES PER: GENERAL AGGREGATE $ 3,000,000
X POLICY PRO- LOC PRODUCTS-COMP/OPAGG $ 3,000,000
AUTOMOBILE LIABILITY $
ANY AUTO
BI tSIN L LI
AALUL O SC
ED HEDULED BODILY INJURY(Per person) i
AUTOS BODILY INJURY(Per accident) s
HIREDAUTOS N�OWNED
AUTOS RP��IDPer =
UMBRELLA LUAB OCCUR =
EXCESS LaAB CLAIMS-MADE EACH OCCURRENCE _
DED R NTI AGGREGATE _
WORKERS COMPENSATION
AND EMPLOYERS,LIABILITY =OPRI S ATI- H
OFFI PCERIMEMBER EXCLUDED?
a N/A
as ' Under
In NH) E.L.EACH ACCIDENT $ -
DESCRI OFA OPERATIONS below E.L.DISEASE-EA EMPLOYE $
E.L.DISEASE-POUCY LIMIT a
DESCRIPTM OF OPERATIONS/LOCATIONS 1 VEHICLES(Attach ACORD 181,Aditoml Remarks ScheduK K MOM space Is required)
RE: My First Tri Race on August 23, 2014.
CERTIFICATE HOLDER
CANCELLATION
SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE
THE EXPIRATION DATE THEREOF, NOTICE WILL BE DELIVERED IN
71880Y
f Centerville ACCORDANCE WITH THE POLICY PROVISIONS
ain St
Centerville, MN 55038 AUTHORIZED REPRESENTATIVE
chael Wilman/STPCT
ACORD 25(2010/05)
iN302s rxl,rnttm Tho Af:nQr1 name anti Inn^aro ronier+arad marks ovF2ArnRnORD CORPORATION. All rights reserved.
My f first i r1 L entervine In LlnO LaKes, MN, u nitea mates I MapMyxun Yage 1 of 2
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MY FIRST TRI CENTERVILLE
My First Tri Centerville AVAIL.POINTS
DISTANCE
01
BEGINS IN: Lino Lakes,MN,United States
2.0
miles CREATED BY: Vicki Ostendorf
CLIMB DESCRIPTION: This is a 2.0 mi route in Lino Lakes,MN,United States. tions
16 ft The route has a total ascent of 16.18 ft and has a
maximum elevation of 895.05 ft.This route was created
by vostendorf(/profile/576974/1 on 07/01/2014.yjgly
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ELEVATION(ft)
891
858
825
792
0 04 0.8 12 1.6 2
CLIMBS ON ROUTE
START ELEVATION MAX ELEVATION GAIN
884 FT 895 FT 16 FT
http://www.mapmyrun.com/routes/view/460287044 7/31/2014
My kirst 1 ri Uenterville in Lino Lakes, MN, United Mates I MapMyKun Page 2 of 2
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Rating Start/End Points Length Start/End Elevation Avg Grade SIMILAR LINO LAKES,MN,UNITED STATES
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MY FIRST TRI CENTERVILLE
START i • •AD
My First TO Centerville AVAIL POINTS
DISTANCE 0 ,
0.25
BEGINS IN: Lino Lakes,MN,United States 3 steps to Fast Maps&Directions
miles CREATED BY: Vicki Ostendorf '1 Click Start Download
2,Free Access-No Sign upl
CLIMB DESCRIPTION: This is a 0.25 mi route in Lino Lakes,MN,United States. 3 Get Free Directions&Maps
0 ft The route has a total ascent of 0.32 ft and has a Of-&emopflrxier
maximum elevation of 870.7 ft.This route was created by
vostendorf(/profile/576974/1 on 07/03/2014.View other
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3A+0.25+mi+Mv+First+Tri+Centerville%OD%OADistance%3A+0.25+mi%OD%OAhtto%3A%2F% TOP COURSES
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ELEVATION(ft) r
891
858 r
825
792
0 005 01 015 02 025
CLIMBS ON ROUTE
17
START ELEVATION MAX ELEVATION GAIN
869 FT 870 FT 0 FT V Get Directioni
CLIMBLearn About Climb Ratmas Uroutes/chmb informaoonA Download Da[a
http://www.mapmyfitness.com/routes/view/462256044 7/31/2014
My rirst Iri Centerville in Lino Lakes, MN, United Mates I MapMyPitness Page 2 of 2
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MAP
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COURSES ON ROUTE
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i NOTES/HOW TO GET THERE
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5 Foods to never eat
Cut domm a bit of killer fat every day
by never eating these 5 foods.
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MY FIRST TRI AUGUST `°"` =`=
My First Tri August AVAIL POINTS
DISTANCE O v
5.
BEGINS IN: Lino Lakes,MN,United States13
Y �'
milesCREATED BY: Jane32002203 w. Directions
tt.
CLIMB DESCRIPTION: This is a 5.13 mi route in Lino Lakes,MN,United States.
92 ft The route has a total ascent of 92.38 ft and has a o�ti�ernp�fmder'
maximum elevation of 911.45 ft.This route was created
by Iane32002203(/profile/32002203/)on 07/11/2014.
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ELEVATION(ft)
990
957
924
891
858
825
792
0 1.03 2.05 3.08 4.1 5.13
CLIMBS ON ROUTE
START ELEVATION MAX ELEVATION GAIN
884 FT 911 FT 92 FT
http://www.mapmyride.com/routes/view/469843570 7/31/2014
My rirst 1 n August in Lino Lakes, MN, Umted States I MapMyKide Paget of 2
CLIMB Learn About Climb Ratings(/routes/climb information/) Download Data TIRED Of SCRATCH®LENSI
_
DETAILS3& krhla FnicnitPnsC,uai:
Rating Start/End Points Length Start/End Elevation Avg Grade SIMILAR LINO LAKES,MN,UNITED STATES
MAP
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2014 SK/81K Walk/Run Sponsors
Centerville Lions 500.00
Waste Management 200.00
Paul Steffel 100.00 1,900.00
Gio Agency 100.00
Central Bank 100.00
Apple Academy Learning Center 200.00
Intense Fitness 100.00
Wu-Long Karate, LLC 100.00
Smith &Glaser 200.00
Healthsource Chiropractic Hugo 100.00
SCSI-Great Lakes/Stantec 200.00
1,400.00